
Wondering what perimenopause is, its symptoms, common myths and treatment options? Not sure what the difference is between perimenopause and menopause? Read on for all the answers…
Perimenopause is the transitional phase leading up to menopause when hormone levels, especially oestrogen, begin to fluctuate. Perimenopause can start as early as your late 30s or early 40s and last for several years. During perimenopause, you might notice irregular periods, shifts in mood and physical changes that feel confusing if you’re not expecting them. Hong Kong GP Dr. Laurena Law of Choy Sum Health explains, “Many women miss symptoms such as mood changes, irritability, sleep disturbance, low energy and unusual joint stiffness and pain.”
Menopause is officially diagnosed after 12 consecutive months without a period, but perimenopause is where many of the symptoms begin — and where early support can make a big difference. Dr. Law says, “The onset of hormonal fluctuations is primarily driven by changes in ovarian function, leading to unpredictable variations in both oestrogen and progesterone levels, along with an increase in the follicle-stimulating hormone (FSH).”
Read More: Everything You Need To Know About Menopause
Jump to:
Symptoms of perimenopause
Perimenopause treatment options in Hong Kong
Women’s health specialists
Perimenopause myths
Perimenopause FAQ
Symptoms of perimenopause
Hormonal ups and downs can affect everything from your brain to your skin. Here are some of the most common (and commonly overlooked) signs of perimenopause:
Brain fog
Misplacing your keys for the third time this week? Trouble concentrating or feeling a bit spaced out? You’re not imagining it — oestrogen plays a role in memory and cognition.
Hot flashes
Sudden warmth in your face, neck or chest, sometimes followed by sweating? Hot flashes can hit day or night and are one of the most recognisable symptoms. A sweltering Hong Kong summer can make this even more unpleasant!
Vaginal dryness
Oestrogen helps maintain vaginal tissue. Lower levels can lead to dryness, irritation or discomfort during intimacy. It’s common — and treatable.
Mood changes
Mood swings, irritability or anxiety can spike during perimenopause and can sometimes be mistaken for mental health issues.
Insomnia or wakefulness
Waking up in the early hours and unable to fall back asleep? Hormonal shifts can wreak havoc on your circadian rhythm.
Change in libido
Some women report a drop in sexual desire, while others notice an increase. Either way, it’s all linked to hormones, and it’s all normal.
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Perimenopause Treatment Options in HK
If you’re suffering from any (or all!) of the above symptoms, don’t worry! Women’s pain has long been dismissed, but awareness around the impact of symptoms of perimenopause and menopause has never been higher. Although our mothers and grandmothers may have suffered through their symptoms in silence, it doesn’t mean we have to.
Here are some of the treatment options your GP might recommend:
Hormone Therapy
Menopausal Hormone Therapy (MHT): MHT is also known as Hormone Replacement Therapy (HRT). MHT supplements declining oestrogen and/or progesterone to relieve symptoms like hot flashes, mood swings and vaginal dryness. MHT is available as tablets, patches, gels or vaginal treatments, and your GP can tailor your treatment based on your symptoms, age and other health factors.
Non-Hormonal Medications
Low-dose antidepressants: Your GP may prescribe these to ease mood changes and even hot flashes.
In addition to SSRIs and SNRIs, there are several other drugs that your GP may prescribe for hot flashes, sleep disturbances and other symptoms of perimenopause.
Sleep Support
Melatonin: Your doctor may prescribe a short course of melatonin, a natural supplement to help regulate sleep-wake cycles.
Sleep hygiene practices: Reducing screen time (especially before bed), keeping the bedroom cool, having a regular bedtime and managing stress can all help improve sleep.
Lifestyle Changes
Strength training & exercise: We’re sick of hearing it, but the biggest change we can make to improve our mental and physical health is exercise. Strength training helps maintain bone density, while regular exercise can help regulate weight and improve mood.
Stress management: Yoga, meditation or therapy can ease anxiety and emotional swings.
Nutrition: Eating more protein, healthy fats, calcium and phytoestrogens (e.g. soy) may support hormone health. A healthy diet is also essential to maintain bone health as we age.
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Complementary and Alternative Treatments
TCM (Traditional Chinese Medicine): Acupuncture and herbal formulas aim to restore balance and ease symptoms.
Supplements: Your doctor may run a range of blood tests to identify any deficiencies, such as low iron or vitamin D. Always consult a doctor before using supplements.
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Hong Kong Women’s Health Specialists
There are many women’s health clinics in Hong Kong, ranging from GP practices that specialise in women’s health to gynaecologists and other hormone health specialists, such as endocrinologists, who can help you get to the bottom of your symptoms.
GPs
Your GP is the best place to start, especially if you’re unsure whether what you’re feeling is hormonal. Some GPs offer blood tests or referrals to specialists. Don’t hesitate to seek a second opinion if you don’t feel like your concerns have been taken seriously.
Dr. Law says that a thorough medical history is critical to exclude medical conditions that may present with similar symptoms. “Some examples are iron deficiency, thyroid disease or sleep apnea. We also look at menstrual cycle changes and cyclical symptoms, as well as medications, past health, family history and lifestyle habits.” According to Dr. Law, a typical assessment might also include checking that screenings such as pap smears and mammograms are up to date. While your GP may order blood tests, blood testing for hormones in most healthy women is not typically recommended.
Gynaecologists
A gynaecologist can confirm your perimenopause symptoms (and rule out other conditions) before guiding you through treatment options like MHT.
Endocrinologists
You may be referred to an endocrinologist if your GP suspects that your symptoms might be related to your thyroid or other endocrine conditions.
Read More: What To Expect From Women’s Health Checks In Your 30s, 40s And 50s
Perimenopause Myths
Dr. Law says a common myth is that menopause only affects women. “While it’s a natural life stage and universal, each woman’s experience is different and will have ripple effects on everybody around her. The menopause transition deserves a holistic and personalised approach.”
MYTH: Perimenopause only affects older women
False! We know many women in their early forties who’ve gone to the doctor about their symptoms, only to be told, “You’re too young to be in perimenopause.” Women can experience symptoms of perimenopause from their late thirties onwards, and it may be years before they go through menopause.
MYTH: I should just put up with my symptoms
False! If your symptoms are affecting your quality of life, you have the power to change that. Just because your mother or your aunt or your friends put up with symptoms like anxiety, hot flashes or sleepless nights, doesn’t mean you have to. Prioritise your wellbeing — this is not the time to be stoic and soldier on!
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Perimenopause FAQ
At what age do women experience perimenopause?
Women can experience symptoms of perimenopause at any time from their late thirties. (This means for some of us, we go straight from baby brain to perimenopausal fog!)
Do I need to see a doctor if I suspect I’m in perimenopause?
It’s not essential to see a doctor purely because you might be in perimenopause. However, you should consider seeing your doctor if the symptoms of perimenopause are impacting you negatively. Dr. Law says,
Perimenopause isn’t a disease, but a natural life transition, and most women will experience a variety of symptom patterns that are unique to them. Women experiencing unusual menstrual changes such as heavy bleeding and pelvic pain, or other symptoms that affect their quality of life, should seek help. It’s also important to rule out other underlying conditions.
Should I see a GP or a gynaecologist about perimenopause?
It’s up to you — you may want to consider factors like your relationship with your regular GP, your insurance and whether you need a referral to see a specialist such as a gynaecologist.
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